Root canal treatment appointments

- How many visits are needed? / How long do appointments last? / Making adjustments for pregnant patients.

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How many appointments does root canal therapy take?

The number of visits it takes to complete your root canal treatment may be as few as one. With some cases, however, two or more scheduled appointments may be required.

a) The two-visit approach.

If two appointments are needed:

  • The first is focused on the task of cleaning and shaping the tooth's root canal system.
  • The second is used for filling and sealing the tooth.
  • The two appointments are usually scheduled about a week apart.

Advantages of this approach are that it makes managing any flare ups that develop easier and more predictable, and it also gives the dentist an opportunity to monitor the progress of the tooth's healing process.

b) Single-visit treatment.

In the past, dentists always broke root canal therapy into two (or more) appointments.

In the 1990's the single-appointment approach began to gain wide-spread acceptance, in part because advancements in technology made it possible to complete a patient's work in a single sitting without compromising treatment quality.


For the patient, the obvious benefit is that all of their treatment is completed in a single sitting. Although, with multi-rooted teeth that visit might be fairly extended, possibly as long as 90 minutes.

Which approach is best?

Research studies suggest that case selection should play the biggest role in deciding which approach is most appropriate.

The primary consideration should be the degree to which the tooth's root canal system harbors infection. Possibly (and this is heatedly debated in the dental community), a two-visit approach that involves the placement of medication (calcium hydroxide) in the tooth between appointments is more effective in disinfecting the tooth's interior.


A) Single-appointment cases.

If a tooth's pathology is limited to just a portion of its nerve tissue (meaning the tooth still harbors some live pulp) then the single-visit approach makes an excellent, possibly even preferred, treatment choice.

This scenario could include teeth that require root canal treatment due to the exposure of their nerve tissue during dental treatment or tooth fracture, and teeth that are in the early stages of pulpal degeneration.

B) Multi-appointment cases.

A dentist performing endodontic therapy for a patient.

In those cases where the entire root canal system harbors bacteria, single-visit treatment may, or may not, be an appropriate choice. This would include teeth whose pulp tissue has died (non-vital, necrotic teeth), teeth with active infections, and retreatment cases.

And as a general rule, if the patient is experiencing pain, tenderness or swelling at the time of their appointment, the dentist will be less likely to choose single-visit treatment.

They will also be more likely to choose a multi-appointment approach for complex cases because they will simply take more time to complete. This might include teeth that have multiple root canals (molars), or teeth that have canals that are generally difficult to find, access or negotiate.

How long does a root canal appointment take?

Over the last few decades, new techniques and new types of equipment have been developed that have improved the efficiency with which endodontic therapy can be performed. And this one reason why single-visit treatment is possible and has become commonplace.

As a ballpark estimate, any single root canal appointment will usually last somewhere between 30 to 60 minutes and, in some cases, possibly as long as 90 minutes.

If you, as a patient, have a preference or a need for short appointments (with the understanding that you will need to schedule more of them) you should let your dentist know. This might include people who have TMJ (jaw-joint) problems or have trouble sitting still for extended periods of time.

On the other hand, some patients may have a strong preference or need for longer, yet fewer, appointments.

Can pregnant women have root canal treatment?

Women who are expecting can undergo root canal treatment. However, the timing of their treatment, and the way it is performed, may need to be altered in consideration for their pregnancy.

In all cases, any woman who is pregnant, or even anticipates that she is, should advise her dentist of such before any type of dental treatment is begun.

Issues that must be considered.

Here are some of the issues that must be taken into consideration when root canal treatment is planned for a pregnant woman:

» The use of radiographs (x-rays).

When utilizing modern radiographic technique, and standard radiation protection (including the use of a leaded apron and thyroid collar), the dental x-rays needed to perform root canal treatment should not place a patient's fetus at risk. However, it is likely that the dentist will strive to keep the number of x-rays taken to a minimum.

» Appointment length and number of visits.

It may be difficult for a pregnant patient to remain physically comfortable while sitting in their dentist's dental chair. Instead of one relatively longer appointment, their root canal treatment may need to be divided up into two or more shorter visits.

» Treatment timing.

In those situations where the patient is experiencing discomfort or has signs of an active infection, immediate attention may be required. In cases where urgency is less of an issue, the treating dentist may prefer to delay the patient's endodontic therapy until a particular trimester (typically the second), or wait until after their child has been delivered.

» The use of medications.

A dentist giving a dental injection.

A patient's pregnancy will influence the selection of medications used for their treatment.

As an example, root canal treatment typically requires the use of a local anesthetic (the medicine that is used to "numb up" a tooth). A few different types of anesthetics have been approved by the FDA for use with pregnant women. And, in fact, they are typically found and routinely used in essentially all dental offices.

Some endodontic cases will also require the use of an antibiotic and/or analgesic (pain reliever). Once again, products approved by the FDA for use with women who are pregnant are readily available.


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